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A newly conducted study is suggesting that mammograms should be done by women at an earlier age so that aggressive breast cancer can be avoided.
According to a study by Harvard Medical School, out of 609 confirmed breast cancer deaths between 1990 and 2007 at Harvard hospitals, 71 percent, or 395, of the victims did not undergo mammogram testing prior to their cancer diagnosis. Half of the deaths were in women not even 50 years old, with only 30 percent of the deaths occurring in women 70 years old or older.
With the study found that the median age of women dying because of breast cancer is 49 and the median age of women withbreast cancer who die of a different cause is 72, it is implied that women under 50 should have more aggressive means of screening against breast cancer.
The recommendation would suggest that patients who have smoked for many years should have low-dose CAT scans of the chest annually to look for early lung cancers. The proposal includes a complicated chart to help physicians assess risk based on age, number of years smoked and number of cigarettes daily. The Task Force cites the growing body of evidence showing that early detection can reduce the number of cancer deaths substantially.
Screening–the practice of looking for disease in asymptomatic patients–has become fairly commonplace for breast cancer, colon cancer, and prostate cancer. Although experts always debate whether the cost of such screening is justified by the savings in medical costs or human life, most primary care physicians now accept that these screening exams should be offered to their patients. And although there are exceptions, many patients want these tests because they hope to take advantage of life-prolonging or even life-saving treatments. Indeed, the practice of recommending screening exams has become so widespread that doctors may be liable for malpractice for failing to offer the tests to their patients. And insurance companies mow regularly pay for these tests.
Yet in many areas, the Task Force has lagged behind other authoritative bodies in recommending screening exams, to the point where malpractice defendants have used the Task Force’s guidelines to justify failing to order tests or treat patients. For example, just last year, the Task Force recommended against prostate cancer screening, placing it at odds with the American Cancer Society and other experts in the field.
It is unfortunate that an organization with such an impressive and official-sounding name often delays in making recommendations that can save lives. While there is certainly an expense and inconvenience–and even some risk of medical complications–associated with screening and diagnostic procedures, most patients with advanced cancer wish they had the opportunity for this potentially life-saving or prolonging testing. The Task Force’s focus on cost per life saved ignores the very real effects of disease on patients and their families.
The Task Force is accepting public comments on its proposal through August 26. Read the proposed Task Force Recommendation here.